The Massachusetts Hospital Association (MHA) contends that the quality and cost-effectiveness of ancillary services utilization in hospitals can be substantially improved through the development and implementation of management strategies designed to modify physician test-ordering behavior. The project will involve a comprehensive analysis of research and practice pertaining to the modification and improvement of ancillary test ordering among physicians so that ancillary services may be more appropriately utilized. The ultimate goal is to produce a document to be made available to health care professionals nationwide that not only reviews published literature, but clearly identified the current status of research and practice, as well as emerging trends in the area of improving the appropriateness of ancillary service use. The report will provide hospital managers with a discussion of specific practical strategies that can be implemented in diverse health care institutions. Implementation of effective strategies will, in the long term, help to improve the quality of health care and to curb the rapid growth of medical costs. This report will be prepared over the course of one year, during which time the following objectives will be accomplished: 1) Complete an exhaustive review of all pertinent information. Information will be collected through literature review and structured interviews with key individuals; 2) Analyze information to determine validity and significance; 3) Synthesize information; 4) Transform information into practical strategies; 5) Write and publish final report, 6) Arrange for publication of report.